Wednesday, November 25, 2015

Polygraph
testing of sex offenders has come in for a good deal of recent criticism.While polygraphy in general, and
post-conviction sex offender testing (PCSOT) in particular, is not without its
problems, many of the negative comments are based on misunderstandings,
misconceptions, and sometimes just plain mischievousness.Other criticisms, however, are based on
genuine concerns, a number of which are eloquently described in a recent blog
by David Prescott (2015).But what is often
unclear is the extent to which these objections are fundamental to polygraph
testing and PCSOT, or whether they relate to poor or outright bad practice in
delivery.

Supporters
of PCSOT argue that it makes an important contribution to sex offender
treatment and management by facilitating disclosure, bringing to attention
changes in risk (both increases and decreases), and encouraging offenders to
modify their behaviour. As these
outcomes are also sought by treatment providers and offender supervisors in
their work with sex offenders, it would seem that it is not the ends of PCSOT that
critics don’t like, but the way in which it gets there.

Objections
to PCSOT are of two types, ethical and practical. As Mark Chaffin astutely observed (Chaffin,
2011), good practice standards are not the same as ethical principles – even where
the delivery of PCSOT is well managed, potential ethical objections don’t disappear. If PCSOT falls at the first, ethical hurdle
then there is little point in carrying on, so it makes sense to start
there.

Ethical
objections are not hard to find. Terms
commonly used in critical commentaries are ‘coercion’, ‘intrusion’, ‘psychological
manipulation’, ‘intimidation’, ‘self-incrimination’, and ‘overriding autonomy’. Many
of this frightening terminology arises from the notion that polygraphy is
primarily about interrogation, stated explicitly by Chaffin (2011) who
described it as “fundamentally a coercive interrogation tool for extracting
involuntary confessions” (p. 320). But
PCSOT need not, and should not, be about interrogation and confession. Instead, it should be seen as an interview
process in which lying is explicitly discouraged but which otherwise mirrors
ordinary interviewing practice. The
questions asked during PCSOT are asked by supervisors and treatment providers already,
and if they’re not then they shouldn’t be asked by the polygraph examiner. Offenders have an opportunity to explain
deceptive outcomes, but they are not intimidated into doing so.

Provided
that the questions asked during the polygraph test are directly relevant to
treatment or supervision, how is it coercive, or morally problematic, to expect
the offender to answer honestly? The
problem comes not with the answers, but when an offender who is judged to be
deceptive in the absence of disclosures is whisked back to jail, thrown off a
treatment programme, or has his progress impeded in some other way on that
basis alone. This is rightly troubling
given the procedure’s error rate, which is probably in the region of
10-20%. It is not, however, a moral
issue for polygraphy, but for how its results are used. A ‘deceptive’ test in the absence of
disclosure should be seen as a warning sign, an indication that something requires
further investigation or attention, but it should not on its own trigger
definitive action. While that may seem a
flimsy use of a muscular outcome, PCSOT is meant to contribute information to
treatment and supervision, not drive it.
To that end, it would be a great help if we moved away from talking
about ‘passed’ and ‘failed’ tests altogether.

Mandatory
PCSOT is of course coercive in that there are penalties for
non-cooperation. But we’re talking about
convicted and usually high risk offenders, who by virtue of their criminal
convictions are required to accept a range of restrictive and coercive measures
such as conditions on where they live, limitations on employment, curfews, and
treatment requirements.

There
is, however, a belief that the way in which information from polygraph testing
is obtained is inherently hypocritical, with examiners deceiving offenders by
telling them that the procedure is error free while at the same time demanding
that the offender should always tell the truth. While this may occur, it is certainly not good
practice, nor is it necessary. Indeed,
the British Psychological Society (2004) stressed that participants should be
informed of known error rates, a sentiment with which it is hard to
disagree. There is no reason to believe
that PCSOT would cease to be effective in these circumstances, and indeed in
our experience it has not happened in the UK where we are honest about error
rates.

Keeping
with the hypocritical theme is another objection that one of the most commonly
used polygraph formats, the ‘probable lie technique’, requires the examiner to
force the offender to lie to some questions in order to compare the response to
answers to so-called relevant questions.
But though this is what tends to be taught, it is not the lie but the uncertainty
of the answer that is probably the basis of the effect. Regardless, those with qualms about ‘probable
lies’ can make use of an aligned technique in which the offender is told to lie
to certain questions, removing any subterfuge and also avoiding the risk of the
examinee admitting to transgressions that have nothing to do with sexual risk.

The
loudest and most forceful ethical objections seem to come from those in the
adolescent treatment world. The increased
vulnerability of juveniles and adolescents, the worry that more harm than benefit may result from their perception
of the process, and the focus on developmental rather than offending issues per
se changes the tone of PCSOT from what it is when used with adults. Indeed, it is not even clear that polygraphy
works in the same way as it does in adults given differences in brain maturity
and psychological development. Whereas
PCSOT in adult offenders has a steadily thickening evidence base, the same
cannot be said for adolescent testing. But
while even critics like Chaffin (2011), who consider the ethical concerns relating
to adolescent testing to be “substantial”, don’t go so far to say that it is
unethical, they rightly argue for more evidence about the impact of its use in
young people. Until this evidence is
produced it is almost certainly right that PCSOT should be used with great
caution in young people, with decisions made on a case by case basis (in the UK
we do not test those under 18 years of age at all), but care must be
taken not to entangle the specific issues associated with testing young people
with polygraph testing more generally.

None
of the ethical objections referred to above would appear to be fundamental to
PCSOT but to how it is delivered. Which
brings us to the more practical aspects of the process.

In
the US the prevailing approach to PCSOT is the Containment Model based on a
triangle formed by treatment provider, offender supervisor and polygraph
examiner. While it has clear attractions
from a public protection perspective, and helpfully stresses the need for
communication between those working with offenders, it implies that all sex
offenders require high levels of external control to keep them from reoffending. Some offenders, however, genuinely seek to
improve their internal controls and engage with treatment and supervision, and
for them the emphasis on containment risks impairing internal longer term
change. For them the containment model
may not be right, but nor is it the only show in town. PCSOT can have a different focus. Remembering that test outcome and disclosure
are complementary, in those who are working with us polygraphy can function as
a truth facilitator, encouraging them to discuss problematic thoughts and
behaviors and provide reassurance that their risk is stable. And though some argue that disclosures simply
represent a ‘bogus pipeline’ effect resulting from the false belief that the
polygraph is a 100% lie detector and is lost once an offender learns otherwise,
all the evidence shows that disclosures continue regardless. Indeed, rather than denigrating the increase
in disclosure obtained in PCSOT we should be looking for ways to enhance the
effect.

There
are associated concerns that the largely controlling approach of the
Containment Model, and by implication PCSOT more generally, may impact
negatively on both therapeutic and supervisory relationships. Arguments to this
effect, however, are based on theoretical rather than empirical grounds. What evidence there is suggests that PCSOT
can in fact improve relationships. It does
not have to carry with it the implication that sex offenders are not to be
trusted. It should be remembered that
polygraphy also catches offenders telling the truth; one should not
underestimate the benefits for an offender who is able to demonstrate that he
is being honest in his dealings with those working with him, and the positive
impact this can have on his relationship with them.

David
Prescott stresses the importance of establishing a treatment culture “in which
honesty and commitment are valued more than the appearance of compliance with
expectations”. There is no reason why
PCSOT, when used properly, cannot contribute to this. He asks, “What level of disclosure is good enough for treatment to be effective?”
(which can just as well be asked about supervision). This is not just a question for PCSOT, but whatever
the answer is it should be the level of disclosure sought by therapists,
supervisors, and PCSOT examiners alike.
The need for ‘complete confession’ or ‘full disclosure’, while perhaps a
feature of some PCSOT programs, does not have to be what PCSOT is about.

Then there are those who
argue that there is little evidence for the efficacy of PCSOT, noting few
studies into reconviction rates. Is
recidivism, however, the right outcome with which to judge PCSOT. PCSOT is about providing information, the nature
of which is determined by therapists and supervisors and which they believe is important
for supervision and treatment generally.
If this information does not contribute to treatment or supervision, and
ultimately a reduction in recidivism, then either the wrong questions are being
asked, or the answers are not being employed effectively. The blame should not be placed at PCSOT’s
door. It seems odd to want it both ways
– to argue that the information provided by PCSOT lacks value and does not
reduce recidivism, but nonetheless we seek it in other ways.

If PCSOT is not to be judged by recidivism rates,
how should it be evaluated? As it is
about information gain surely attention should be focused instead
on the value of the information provided – the frequency and content of
disclosures, the impact of test outcome on decision making, and actions taken
after a polygraph test can all form part of a cost-value analysis to determine
the value added by PCSOT compared with the cost of administering it. In other words, to what extent does PCSOT better
enable probation officers to monitor risk and initiate timely interventions,
and allow therapists to more accurately identify and address treatment targets?

Where
the critics have it right is their observation that the process depends on
competent polygraph examiners and well-designed and governed PCSOT programs. Examiners must be properly trained and
supervised, the protocols they work to sound, and their work subject to
rigorous quality control. The tendency
to go for those with the cheapest rates or the flashiest websites needs to be
resisted, and there lies the basis of potential problems.

In
the end, one might ask whether it is unethical not to use PCSOT in the treatment and supervision of sex
offenders. If the information obtained
during a polygraph examination adds significantly to what is otherwise known
about treatment need and risk, is it right to deny the potential benefits of
PCSOT to an offender? If PCSOT does
reduce risk, how can one explain to a future victim why it did not form part of
the offender’s treatment and supervision package? While the evidence for PCSOT is supportive
rather than conclusive, objections tend to rely on opinion rather than
fact.

Those
who make use of PCSOT must know the right questions to ask of it, how much
weight to give its results, and how to integrate it with everything else they
do with an offender. More thought needs
to be directed to which offenders are most likely to benefit, the needs that can
best be targeted in those offenders, and whether modifications are necessary
depending on the characteristics of the individual taking part (sounds a bit
like the ‘risk-needs-responsivity’ principle).
In the end, that is an argument for enhancement, not abandonment.

Don
Grubin MD FRCPsych

References

Chaffin, M.
(2011). The case of juvenile polygraphy as a clinical ethics dilemma. Sexual
Abuse: A Journal of Research and Treatment, 22:314-328.

Friday, November 20, 2015

ATSA has long enjoyed a friendship with the
Australia and New Zealand Association for the Treatment of Sexual Abuse
(ANZATSA). I had the honor of attending their biannual conference this month,
and wanted to share some impressions in the event that it is useful.

There is a saying among historians that
“Happy is the nation that has no history.” In other words, it can be painful to
reflect on the history of one’s country, and this couldn’t be more true in the
case of Australia and New Zealand (and elsewhere). At a time when so much of
the world is grappling with problems related to human migration, the ANZATSA
conference began with traditional greetings from an Elder of the Wurundjeri
people (caretakers of the land on which the conference took place) and a Maori
delegate from New Zealand. It is one thing to hear about this kind of opening
and another to experience it. It was an important way to open the conference,
as in many places in Australia, aboriginal people made up 2-3% of the general
population and 70-80% of of incarcerated people. Addressing abuse in this
context cannot be meaningful without explicit discussion of the systematic
racism that occurs in these and other countries, including the USA and Canada. One
ANZATSA attendee related to me that she could only become an Australian citizen
at the age of seven because, as an Aboriginal, she had “fallen under the Plants
and Animals Act.”

The first keynote addressed more
immediate problems facing aboriginal people in that part of the world, before
the conference turned to practice matters such as research and practice related
to therapeutic engagement. Nicola Gavey, a Professor of Psychology at the
University of Auckland, New Zealand, spoke on the topic of rape culture,
focusing on the incidents and subsequent media coverage in Steubenville, Ohio,
and the Roast Busters scandal of 2013 in New Zealand. The conference program noted that her 2005
book Just Sex? The cultural scaffolding of rape received a Distinguished
Publication Award from the Association for Women in Psychology. Her current
project ‘Pornography in the Public Eye’, raises questions about the gender and
sexual politics of mainstream pornography.

Arguably, the most stunning
presentation was by Louise Nicholas, who has established herself as a national
treasure in New Zealand. She is a National Sexual Violence Survivor Advocate in New Zealand. She is a
survivor of child and adult rape, perpetrated against her by rogue members of
the New Zealand Police. While there are many people who have survived sexual
abuse and gone on to tell their stories via books and lectures, Mrs. Nicholas
stands out. Her presentation was passionately heartfelt and authentic. It was
clear that she had come to tell the truth from her first words: “Some names
have been changed due to suppression orders by the court.” Mrs. Nicholas’
persistence in seeking justice for herself and others is remarkable. There is
now a wing of the New Zealand police named after her. In April 2015 she was awarded the
Governor General's Anzac award and later same year (June) she was made an
Officer of the NZ Order of Merit in the Queens Birthday Honours. Louise co-wrote the bestselling
book Louise Nicholas – My Story, which was later made into a film.

Tony Ward followed with an exceptional
keynote derived from a special issue of Psychology,
Crime, and Law that he is editing with Clare-Ann Fortune. In essence, he
argued that the current state of our understanding of dynamic risk factors (and
by extension, protective factors) risks bring our field to a dead end unless
research can better separate correlation and causation, and develop more
explanatory models. He illustrated his point using the risk factor of emotional
congruence with children, and outlining different ways it could result in
sexual abuse. Without a keener eye turned to the nature of explanatory forces,
he argued, our understanding of risk factors is less helpful than we are
capable of, and the factors themselves reified constructs without explanatory
power. As one might expect, Tony was passionate in his style. The special issue
certainly promises to be as provocative as it is thoughtful.

The ANZATSA workshops were also very
worthwhile. Caroline Burrowes presented on a 10-week trauma-focused curriculum
using Acceptance and Commitment Therapy, while Fernanda Mottin gave an engaging
talk on how she anchors her practice in Dan Siegel’s interpersonal
neurobiology. All in all, the conference was an excellent experience, and the setting
of Melbourne made it a great time for all. Good things are happening in
Australia and New Zealand!

Friday, November 13, 2015

Most risk assessment scales are developed and
validated by researchers based on file information scored by research
assistants, who may have extensive training in the behavioural sciences, but no
field experience. An essential question is whether the accuracy of these
research studies will be similar to the results of real cases assessed by
front-line staff. In other words, how can we implement a scale so that it works
with similar (or even better) accuracy as research studies? Before delving into
concrete recommendations for conducting high quality assessments, I will first
use an illustrative example and summary of research to demonstrate that the
commitment of individual staff members and organizations can make a huge
difference in how well a risk assessment scale will work.

Illustrative Example: A Tale of Two States

Static-99 (and its revised version,
Static-99R) is the most commonly used sex
offender risk scale and there are over 60 studies of the scale, which have
found that on average, it has moderate predictive accuracy. Unfortunately though, there are very few studies of how it works in
field settings.

Among many states to mandate the use of
Static-99/R for imprisoned sex offenders are Texas and California. Texas found low
predictive accuracy – their results were
lower than most studies of the scale. In contrast, California found remarkably high levels of predictive accuracy – their results were among the best of all
studies conducted on the scale, or any other risk scale.

How could two American jurisdictions
implementing the same risk scale achieve such remarkably different results?

There are many methodological or policy
differences that could affect these findings, but at least part of the difference
likely has to do with the quality of implementation. The study from Texas
provides no information on how the correctional system maintains the quality of
their risk assessments. In contrast, California has a remarkably rigorous
implementation and quality control system. All staff who use the scale must be
trained by someone certified by the Static-99R developers or a ‘super trainer’
who is certified by a certified trainer and has at least two years of scoring
experience. All staff receives training from a detailed, standardized
curriculum and by law, they must be retrained in the scale every two years.
Additionally, they must pass scoring tests after training, and ideally, their
first 10-20 cases are reviewed by a super trainer. Novice users are also encouraged
to work with a mentor to maintain the quality of their assessments. With such
diligent attention paid to the quality of their risk scale implementation, it
is not surprising that California has found some of the highest predictive
accuracy ever obtained in a field setting for a risk assessment scale.

What Can Staff and Organizations Do to Promote High Quality
Assessments?

The jurisdiction examples and research
discussed above show that it is not enough merely to implement a risk
assessment scale. Care should be taken to ensure the assessments are done well.
This is particularly important given that any risk assessment conducted can be
challenged in court.

Below is a list of policy and procedures that
are recommended by the developers of the STABLE-2007 (Fernandez, Harris,
Hanson, & Sparks, 2014) to keep quality high. This list was modified to be
applicable to all risk scales, and is included with permission of the scale
authors.

All
risk assessment practices should have most, if not all, of the following
components in place:

1.
A Bring Forward system to cue when it is time to re-assess scorings, ensuring
regular scorings (applicable for dynamic risk assessment scales).

2.
A system of peer reviews so that everyone is working towards scoring
calibration (i.e., all scoring the same case alike). Colleagues should meet on
a regular basis and present
their scorings to each other and discuss the scorings, working towards
consensus.

3. Clinical supervision by a very experienced assessor
so that those scoring have access to a resource person for tricky questions
(this person may well organize the peer review sessions).

4. Mentorships with those who are more experienced in
using the measure so that novice scorers have an identified person with whom
they can discuss their cases and their risk scoring.

5. Participation in inter-rater reliability trials
where about 10% of the cases are scored by more than one rater and the scores
are compared. This technique leads to better calibration of scoring.

6. Your agency may wish to consider participating in
webinars about scoring and other risk assessment issues.

7. When scoring risk assessments on any offender a
jurisdiction should have a quality control process in place, either through
regular professional development days, internal supervision by senior employees
who are committed to the risk assessment process or possible “scoring clinics”
run cooperatively within organizations.

Friday, November 6, 2015

Since 2009, National Police Chiefs’
Council (NPCC) –previously known as ACPO and the National Offender Management
Service (NOMS) have been developing a dynamic risk assessment framework, to
assist offender managers in both organisations to manage sex offenders. It has strengthened
the Police’s ability to manage registered sex offenders (RSO’s) more
effectively and efficiently. Highlighting the risk they pose at the here and
now, together with the historic risk they had been assessed at.

Active
Risk Management System (ARMS) was primarily developed to address the gap in
England and Wales created by the lack of an agreed and consistent approach to
evaluating dynamic risk and protective factors in adult male sex offenders so
that a defensible risk management strategy or case formulation can be completed.
Learning from research and current understanding of the role played by these
factors and combining outcomes into a case formulation that measures progress
in the management of the offender, which has been one of the core aims in the
development of ARMS.

ARMS guides offender managers through
the risk assessment process and into a case formulation for each offender. The
framework focuses on the current evidence for these factors which are derived from
information from the offender, environment, agencies and third party sources.

ARMS has 11 factors which are broken
down into 7 risk indicators and 4 protective factors, these cover areas like
opportunity to offend, sexual preoccupation, offence related sexual interest,
positive routine, social investment and commitment to desist.

Rather
than labelling the offender with a risk level the Police have identified the
priority for work to be given to reduce the risk and strengthen the protective elements
of the management of the offender that will guide the assessor in arriving at a
general level of priority for work to be completed.Once assessed the professional is required to
consider the Risk Matrix 2000 assessment of re-conviction and by combining these
two assessments arrive at the general level of risk management.It is this general level of risk management
that will guide the timetabling of future engagements with the offender.

The
re-defining of the concept of risk is argued will provide something more
meaningful and have a direct relationship with work, action and investigation.

A
particular strength of ARMS has been its ability to draw these assessments
together to arrive at a risk management strategy that over time will measure
the effectiveness of the Police’s and National Probation Service actions and
provide the framework for intervention.

The
Police have been using ARMS since October 2014 and have completed thousands of assessments
across England and Wales. ARMS is used in every Police Force by the MOSOVO
(Management of Sex Offenders Violent Offenders) officers. These officers now
conduct a more thorough, intrusive and challenging conversation with offenders
so they can obtain the most complete assessment that is possible in the
circumstances. This has involved better training for officers to understand the
complexities of such conversations by asking more in depth questions about
their behaviour, thoughts and plans.

When
officers started to use ARMS and change the way they had conversations with
offenders, some found it a real challenge. This represented a cultural change for
the Police to understand that to assist an offender from reoffending they had
to engage in a more meaningful and sometimes intrusive way to fully recognise
what an offender was thinking, fantasying and planning to do. This has led to more
comprehensive assessments of offenders which has allowed officers to adjust the
overall level of risk. The result of this is that resources are now more
effectively and efficiently managed with fewer RSO’s being managed at very high
and high risk without effecting public safety. This has been a very successful
change in Police’s management of RSO’s and represents the biggest single change
in practice since this area pf work started in the late 1990’s.

Duncan
SheppardIf you have any further queries please contact DCC Skeer’s staff officer T/Insp Helen Harkins, Mark Blandford, ARMS developer for National College of Policing, or DCI Duncan Sheppard –MAPPA National Policy lead for Police in England and Wales.

Kieran McCartan, PhD

Chief Blogger

David Prescott, LICSW

Associate blogger

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The Association for the Treatment of Sexual Abusers (http://atsa.com/) is an international, multi-disciplinary organization dedicated to preventing sexual abuse. Through research, education, and shared learning ATSA promotes evidence based practice, public policy and community strategies that lead to the effective assessment, treatment and management of individuals who have sexually abused or are risk to abuse.

The views expressed on this blog are of the bloggers and are not necessarily those of the Association for the Treatment of Sexual Abusers, Sexual Abuse: A Journal of Research & Treatment, or Sage Journals.

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